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911 Call Information
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Email
*
Your email
Today's Date
*
MM
/
DD
/
YYYY
Phone number used to call 911
*
Your answer
Name of person who called 911
*
Your answer
Name of person the 911 call was about, and DOB
*
Your answer
Address where emergency personnel were dispatched
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Your answer
Names of any additional involved parties
*
Your answer
Date/Time of 911 call
*
Your answer
Description of 911 event
*
Your answer
Name of hospital if victim was transported for medical assist
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Your answer
List the type of responders who attended (Police, Sherrif, EMTs, Ambulance, etc.)
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Your answer
Can you provide any incident report or report number?
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Your answer
Was anyone arrested? If so, who?
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Your answer
Are any of the listed people minors? If so, who?
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Your answer
Are you willing to provide photo ID and sign a release form if required?
*
Yes
No
Required
Any additional information which might prove helpful
Your answer
I agree to pay a $50 nonrefundable deposit and understand that Get911Calls will send the deposit invoice via PayPal under the company name Keen Daddy Media, LLC.
*
Agree
I understand that until I pay the $50 deposit, no research will begin on my 911 audio request.
*
Yes, agree
Required
I understand that there may be a waiting period and that time period is determined by the Custodian of Records, not Get 911 Calls.
*
Yes
I understand and agree that, if the 911 call copy is retrieved by Get 911 Calls, I am responsible to pay the balance of $80 in order to receive the audio file; and once I have paid the balance, Get 911 Calls will provide the audio.
*
Yes
I understand that I am at liberty to decline the audio and will not be required to pay the $80 balance, but I will not receive the audio file if I decline to pay. I also understand that if I decline the audio, I am not entitled to the deposit ($50) refund.
*
Yes
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